Definition

Impotence is the inability to attain or maintain an erection of the penis that is firm enough for sexual intercourse.

To initiate and maintain an erection, the penis must fill with blood. One type of blood vessels open wide to allow blood into the penis. Meanwhile, a second type of blood vessel squeezes down to keep the blood from leaving the penis. Nerve signals cause the proper changes in the blood vessels.

Causes

The following factors can cause erectile dysfunction:

Venous Leak

The blood vessels that keep the blood from leaving the penis may be injured or have disease. This can cause a leak in these vessels. Blood can escape through these leaks during an erection. This means that an erection cannot be made or may not last long.

Neurovascular Function

Problems with the nerves and blood vessels can cause impotence. Conditions that can cause problems include:

Nerve dysfunction—can reduce feeling in the penis, resulting in impotence

Symptoms

Symptoms include:

A less firm penis

Fewer erections

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Expect questions about the frequency, quality, and duration of your erections. Your answers may help the diagnosis.

Your bodily fluids may be tested. This can be done with blood tests.

Nocturnal Penile Tumescence Testing

This test will monitor erections while you sleep. Involuntary erections during sleep are normal. If you have impotence but have normal erections during sleep, the problem may be emotional. If you have problems with an erection even while you sleep, the problem may be physical.

Imaging

Doppler
imaging is used to look at the blood flow. The test is done to check for blood flow in the penis. It will also look for blockage in the arteries or veins that supply the penis.

Treatment

Treatment options include:

Medications

Your doctor may prescribe:

Phosphodiesterase inhibitors

Do not take these medications if you are also taking nitrates.

Oral testosterone , if you have low testosterone levels

Alprostadil , either injected into the penis or inserted into the urethra as a suppository

Use caution and talk to your doctor before taking any over-the-counter medications for impotence. Some of them may be unsafe.

Vacuum Devices

A vacuum device
pulls blood into the penis. A band will then be placed around the penis to keep the erection.
A vacuum device may include:

Plastic cylinder for the penis

Hand pump for pumping air out of the cylinder

Elastic band for holding the erection after removal of the cylinder

Vascular Surgery

Vascular surgery is done to repair the blood vessel leaks. This has been shown to be effective in some cases.

Penile Implants

Implants may be placed in the penis. The implants can be inflated to simulate an erection.

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at
HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.